Inside Health

By DAVID M. HERSZENHORN and ROBERT PEAR

Published: February 19, 2010

WASHINGTON -- President Obama will put forward comprehensive health care legislation intended to bridge differences between Senate and House Democrats ahead of a summit meeting with Republicans next week, senior administration officials and Congressional aides said Thursday.

Democratic officials said the president's proposal was being written so that it could be attached to a budget bill as a way of averting a Republican filibuster in the Senate. The procedure, known as budget reconciliation, would let Democrats advance the bill with a simple majority rather than a 60-vote supermajority.

Congressional Democrats, however, have not yet seen the proposal or signed on.

The House and the Senate each adopted a version of sweeping health care legislation late last year. But efforts to combine the measures stalled after a Republican, Scott Brown, won a special Senate election in Massachusetts on Jan. 19, effectively stripping the Democrats of the 60th vote they needed to overcome Republican filibusters.

''It will be a reconciliation bill,'' one Democratic aide said. ''If Republicans don't come with any substantial offers, this is what we would do.''

Officials said that the White House would post the president's plan on the Internet by Monday morning. But even as Mr. Obama tries to unite his party behind a single plan, it is unclear that Democrats can muster the needed votes in the House and the Senate given the tense political climate of a midterm election year.

During a conference call on Wednesday night, the House speaker, Nancy Pelosi, told the White House chief of staff, Rahm Emanuel, and the Senate majority leader, Harry Reid, that she could not agree to a proposal until rank-and-file lawmakers returned from a weeklong recess. A House Democratic caucus meeting is set for Monday evening.

And a senior Senate Democratic aide expressed doubts.

''It has been three weeks since the Massachusetts election, and we have not received a path forward from the White House on health care substance and process that can clear the House and Senate,'' the aide said.

Democratic officials said the president's proposal, like the House and Senate bills, would insure more than 30 million Americans by 2019, at a cost of about $900 billion.

Kathleen Sebelius, the secretary of health and human services, said the president would ''take some of the best ideas'' from the House and the Senate and ''put them into a framework.''

''There will be one proposal,'' Ms. Sebelius said.

The president's plan would require most Americans to obtain health insurance or face financial penalties; it would bar insurers from denying coverage based on pre-existing medical conditions, and it would give tax subsidies to help moderate-income people buy private insurance.

Officials said the president's bill was expected to include a version of the Senate's proposed tax on high-cost, employer-sponsored insurance policies. It would reflect a deal reached with labor union leaders to limit the impact of the tax on workers.

More recently, some labor officials have expressed dissatisfaction with that deal, and many House Democrats remain opposed to the excise tax.

Democrats said it was still unclear how the president would deal with other disagreements, including the issue of insurance coverage for abortions.

Abortion remains ''a wild card,'' said a Democrat on Capitol Hill.

In laying out his vision for next week's meeting, Mr. Obama has said that he will present a unified Democratic proposal and invite Republicans to offer alternatives. But Republicans have warned Democrats not to finalize their plan, which they said reflected an effort to predetermine the outcome of the meeting.

Congressional Republicans have not said they will attend the summit. House Republicans on Thursday repeated their demand that Democrats discard the existing proposals and start over.

''We have this event to discuss areas of agreement, and then what?'' asked Michael Steel, a spokesman for the Republican leader, Representative John A. Boehner of Ohio. ''How will they incorporate our ideas? Will they abandon their plans to jam through their latest backroom deal? Or is this just an infomercial for the same government takeover of health care that the American people have rejected again and again?''

Mr. Obama has rejected the calls to start over, but aides have said that he is open to adopting Republican ideas.

In recent days, White House officials have consulted with Ms. Pelosi and Mr. Reid, but have not reviewed Mr. Obama's plan with other Democratic lawmakers.

''There has not been a collaborative process,'' said a Congressional Democrat with decades of health care experience. ''We have not been consulted. This is very much a White House proposal.''